Information Collection

Pilot Test on Sampling NHIS Nonrespondents – 2020, R1 only of MEPS Core

IC 236883 under ICR 202209-0935-003 · OMB 0935-0118.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0118 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 108 Pilot Test on Sampling NHIS Nonrespondents – 2020, R1 only of MEPS Core	Form and Instruction
108 Attachment 108 - Household Component Core Instrument Lin Attachment 108 - Household Component Core Instrument link.docx	Form and Instruction
108 Attachment 108 - Household Component Core Instrument Lin Attachment 108 - Household Component Core Instrument link.docx	Form and Instruction

IC Title:

Pilot Test on Sampling NHIS Nonrespondents â 2020, R1 only of MEPS Core

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	108	Attachment 108 - Household Component Core Instrument Link	Attachment 108 - Household Component Core Instrument link.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	307	307
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.